Rep. Jim Cooper: House health care bill was 'one of the best votes I ever cast'

Rep. Jim Cooper (D-Tenn.) knows as much about health-care policy as anyone in Congress. He teaches the subject back home in Tennessee, promoted his own plan (to the anger of many Democrats) in 1994, and has been both a vocal advocate and critic of this year's reform fight. On Saturday, he voted for the House's health-care bill. Earlier today, he told me why.

What was the weekend like for you?

This was one of the best votes I ever cast. The key is to keep the reform process alive. There are many things in the House bill I disagree with. But the Senate bill is the more likely final product due to the difficulty of getting 60 votes over there. If we had dropped the baton at this stage, it wouldn’t have given the Senate a chance to improve the bill. It would have given the House what amounted to a one-chamber veto. The Senate could have powered through, but those folks are not noted for their courage. The House had to perform here. And I am thankful that in the nick of time the leadership realized how short they were on votes.

The slim margin surprised many observers. Do you buy the argument that there were a number of congressmen who would have voted for the bill if they’d been needed?

I think the actual number was closer to 210. The leadership had to move heaven and earth to get to 220. The achievement of the leadership was to corral the votes at the last minute, and that is a great achievement that should not be diminished, and they did that by making major concessions they didn’t want to make.

Those concessions all pointed in one direction. The public option was weakened, the vote on single payer was jettisoned and abortion rights were curtailed.

I really wasn’t involved in those processes. The failure of any vote on single payer was amazing to a lot of Democratic stalwarts. So was the permission to vote on Stupak and the large vote in favor of Stupak. One of the papers quoted Rep. George Miller saying there’s a pro-life majority in Congress. That’s painful for a lot of folks, but it’s the reason the Stupak compromise was necessary. The bill would’ve failed without that.

The argument over Stupak’s amendment was striking for how effectively it evaded questions of choice and focused on the Hyde amendment. They narrowed that debate very sharply.

They won the argument that their amendment was the continuation of current law. It shows how popular the status quo is. That’s the major problem health-care reform has always had. People prefer the devil they know. The default position is usually to do nothing.

But the debate is a continuing education process. Before the Stupak amendment, many of my friends had not realized that the government gives a $250 billion annual subsidy to employer-sponsored health care. If you understand today’s system, the Hyde amendment bans direct subsidies of abortion. It does not ban indirect subsidies of abortion, in particular the $250 billion that goes to employer-based health care. The bishops never noticed that. But this is the way education works in a democracy. It’s not easy or simple. But when people begin making decisions, they learn about lots of things they never noticed before.

It's the same with procedural things. In the Rules Committee’s explanation of the Stupak amendment, they said flat out that the Stupak amendment codifies the Hyde amendment. Most people didn’t realize that that’s the description from the Stupak amendment’s advocates, not necessarily the judgment of the Rules Committee’s staff. Like many things in Congress, lots of folks did not pay attention to the details. It looked like it just continued current law. But this turned out to be very important.

What was your role in the final days?

Exhausting, round-the-clock, nonstop small-group meetings that were part seminar and part therapy. What the bill went through was a near-death experience. One of the climactic moments was the caucus meeting two or three weeks ago. They took a public whip count. Normally whip counts are private. So this was astonishing to many members.

The specific question was whether you were for a robust public option or not. And they just went through the names. Early in the alphabet, one member answered that he was for that, but against the overall bill. Someone in leadership shouted out that that meant you were against the whole thing. So it became about reform as a whole. There were a shocking number of committee chairmen and regular members, not Blue Dogs or anything, who said they were against the reform. Jaws started dropping around the room.

The tension was incredibly ugly. It was one of the worst meetings I’ve ever been to. Later in the roll call, someone said he’d be for the bill if we had better negotiation for drug prices. Than leadership said that was in the bill. Then someone yelled out, “how would we know?” Nobody had seen anything!

Now that the bill is out, negotiation for better prices is in the bill, and in the very next paragraph, they ban the use of formularies, which voids the negotiation. That’s why CBO scores it at 0. If you look at substance, is negotiation in the bill? I think it’s still not in the bill. This is one of the thousand provisions where you had to scratch your head and ask who were we trying to fool here? It sounds to me like Billy Tauzin won that one.

Maybe not in the procedures, but Cooper did his part to fight progressive reform and a public option over the months, and in the face of his constituents. Markos had his number. But apparently pressure and poll numbers finally pushed Cooper along.

I'd still take the House language on Medicare Drug Price negotiation--hamstrung though it is--because a determined Secretary has other negotiating tactics at her disposal. That being said, with Obama and Reid both promising to honor the backroom PhRMA deal, nothing the House did on drugs stands a chance. And PBM stocks concur.

One of Cooper's secrets is that he was one of Obama's health policy advisers during the campaign, which is usually unmentioned during interviews like this one. He endorsed Obama early and they're presumably close, so I suspected he would come around eventually.

As one of his actual, real-life constituents, I was planning on supporting any attempt to primary him before, but my feelings on him have moderated now. Cooper is extremely popular here and the Daily Kos-led discussion of primarying him was greeted with raucous hatred in the local blogosphere. I think he's a good Representative when he's not hemming and hawing about the House bill, and now that he's voted for it I doubt he'll face any primary, and I'd vote for him if he did.

"...someone said he’d be for the bill if we had better negotiation for drug prices. Than leadership said that was in the bill. Then someone yelled out, “how would we know?” Nobody had seen anything! "

Now that the bill is out, negotiation for better prices is in the bill, and in the very next paragraph, they ban the use of formularies, which voids the negotiation. That’s why CBO scores it at 0.

If you look at substance, is negotiation in the bill?

I think it’s still not in the bill.

This is one of the thousand provisions where you had to scratch your head and ask who were we trying to fool here?

It sounds to me like Billy Tauzin won that one."

Now are beginning to see some distrubing information that needs to be addressed by POTUS or RG-

and I am a supporter-

So maybe one of those so called 'questionnaires' in the press room can ask RG

HUFFPOST:

"Big Pharma members that stand to benefit from current health care reform proposals -- particularly after the White House cut an $80 million deal with the industry

Tony, Heather, and John Podesta visited the White House 25 times between the three of them in just the first six months of the year, according to the White House's recently-released visitor logs -- a better advertisement for Tony and Heather Podesta's firms in the change era than they could possibly ask for."

While there are some major positive components of meaningful reform in the House bill, it is evident that little is done to curb or brake the growing power of special interests and industry lobbyists.

The Cooper interview illustrates just how poorly informed many Members of Congress, especially in the House really are on important matters of legislation. Too many don't take the job----which is making laws---sufficiently seriously. Of course, the system we have in place virtually guarantees that they spend as much, or in some cases more, time running for reelection than they actually do actually legislating.

Members of Congress spend far too much time in their Districts and Senators too much time in their states raising money, and far too little actually at work learning the intricacies of issues, and developing policy expertise. Representatives and Senators should be policy experts in the policy jurisdictions of the Committees on which they serve. They also need to be policy generalists, such that they bring a capacity to engage intelligently on all issues of public policy. Any Member of Congress who does anything less is not worthy of the job.

The way Rep. Cooper talks about the Stupak amendment unhelpfully evades the important point that he voted FOR it. He refers to "the Stupak amendment’s advocates" as if he hadn't joined the group.

As a congressman, Cooper had the right to vote for this amendment. It would be nice if he didn't hide from the vote he cast just days ago. I'd like to hear his reasoning for robbing a woman of her right to make a healthcare decision for herself, and instead handing that decision to the government.

Very interesting"
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Of which $50-75 billion goes to private insurers' pockets. But only about $10-15 million falls into the election funds of congress. By any rational measure of business that's a bargain for the insurers and a ripoff of taxpayers.